《全生指迷》论曰∶寒热之病,或寒已而热,或热已而寒。若寒热战栗,头痛如破,身体拘急,数欠、渴欲
饮冷。或先寒而后热,或先热而后寒,或 时而发,或间日而作,至其时便发,已即如常,此谓之疟。疟脉自
弦,弦数多热,弦迟多寒。此皆得之于冬中风寒之气,寒气藏于骨髓之中,至春阳气大发,邪气不能自出,因
遇大暑,而后与邪气相合而发。寒热等者,宜调之,与鳖甲汤。(方在门中。)
《圣惠》治小儿疟疾,发歇寒热,体颤。黄丹丸方
黄丹(微炒) 常山(末。各半两) 虎睛(一双,酒浸、炙令黄)
上件药同研令细,炼蜜和丸如梧桐子大。每未发前,以温水下二丸。五岁以下可服一丸。
《圣惠》治小儿疟疾发时壮热,增寒面色青黄,饮食不下。常山丸方
常山 川大黄(锉碎,微炒) 甘草(炙微赤,锉。各半两) 麝香(半钱,细研)
上件药捣,罗为末,研入麝香令匀,炼蜜为丸如梧桐子大。每临发前以暖水下二丸。三岁以下即服一丸。
《圣惠》又方
上蛇蜕皮灰细研为散,于未发前,以冷水调下一字。二岁以上即服半钱。
《圣惠》又方(与疟疾热而后寒门中《千金》方同。两疟皆可用,故并存之。)
上用鳖甲一两烧灰,细研为散。于未发前,以温酒调下半钱。三岁以下,即服一字。
张涣治疟疾,桃仁汤方
桃仁(汤浸,去皮尖、双仁,麸炒黄) 鳖甲(酥炙微黄,去裙 。各一两) 桂心 黄芩 赤茯苓 川
升麻(各半两)
上件捣为粗散。每服一钱,水一小盏,煎至五分,去滓温服。量儿大小加减。
《全生指迷》鳖甲汤
鳖甲(汤浸刮令净,醋炙) 白术 常山 桂(去皮) 柴胡(去苗,各一两) 牡蛎(半两,火 赤)
上为粗散。每服五钱,水二盏,煎至一盏,去滓温服。
《全生指迷》论述说:寒热交替的疾病,有时是寒冷消退后发热,有时是发热消退后发冷。如果出现寒战发抖、头痛剧烈如破裂感、身体拘挛紧急、频繁打哈欠、口渴想喝冷水等症状。或者先感到寒冷随后发热,或者先发热随后发冷,或者定时发作,或者隔日发作,到了特定时间就发作,发作过后就像正常人一样,这称为疟疾(Malaria)。疟疾的脉象自然呈现弦脉(String-taut pulse),弦而数的脉象多属热证,弦而迟的脉象多属寒证。这些病症都是因为冬季感受了风寒邪气,寒气潜伏在骨髓之中,到了春季阳气盛大发散时,邪气无法自行排出,如果遇到大暑天气,便与邪气相合而发病。对于寒热程度相等的情况,适宜进行调理,使用鳖甲汤(Turtle Shell Decoction)。(方剂见本门中。)
《太平圣惠方》治疗小儿疟疾,发作时寒热交替,身体颤抖。黄丹丸方:
黄丹(轻微炒制) 常山(研末。各半两) 虎睛(一对,用酒浸泡、炙烤至黄色)
以上药材一同研磨成细末,用炼蜜调和制成梧桐子大小的丸剂。每次在发作前,用温水送服二丸。五岁以下儿童可服用一丸。
《太平圣惠方》治疗小儿疟疾发作时高热,恶寒加重,面色青黄,饮食难进。常山丸方:
常山 川大黄(切碎,轻微炒制) 甘草(炙至微红,切碎。各半两) 麝香(半钱,细研)
以上药材捣碎,过筛成粉末,加入麝香研匀,用炼蜜制成梧桐子大小的丸剂。每次在即将发作前,用温水送服二丸。三岁以下儿童服用一丸。
《太平圣惠方》又一方:
将蛇蜕皮烧成灰,细细研磨成散剂,在发作前,用冷水调服“一字”量(古代容量单位)。两岁以上儿童服用半钱。
《太平圣惠方》又一方(与本门中《千金方》治疗疟疾热后发冷的方子相同。两种疟疾均可使用,故并存记录。)
取鳖甲一两烧成灰,细细研磨成散剂。在发作前,用温酒调服半钱。三岁以下儿童服用“一字”量。
张涣治疗疟疾,桃仁汤方:
桃仁(热水浸泡,去皮尖及双仁,麸皮炒黄) 鳖甲(酥油炙至微黄,去除裙边。各一两) 桂心 黄芩 赤茯苓 川升麻(各半两)
以上药材捣成粗散。每次服用一钱,用水一小盏,煎煮至五分水量,去渣温服。根据患儿大小酌情加减。
《全生指迷》鳖甲汤:
鳖甲(热水浸泡刮净,醋炙) 白术 常山 桂(去皮) 柴胡(去苗,各一两) 牡蛎(半两,火煅至红)
以上药材制成粗散。每次服用五钱,用水二盏,煎煮至一盏水量,去渣温服。
Quan Sheng Zhi Mi (Guide to Understanding Complete Life) states: In diseases characterized by alternating cold and heat, sometimes the cold subsides followed by heat, or the heat subsides followed by cold. If there are symptoms such as chills and trembling, severe headache as if the head were bursting, bodily stiffness and urgency, frequent yawning, thirst with a desire to drink cold fluids, or if one feels cold first then hot, or hot first then cold, or if it occurs at regular intervals, or every other day, occurring precisely at its appointed time and resolving to normalcy afterwards, this is termed Malaria (Nue). The pulse of Malaria is naturally wiry (Xian). A wiry and rapid pulse indicates excess heat, while a wiry and slow pulse indicates excess cold. These conditions arise from contracting wind-cold pathogens in winter; the cold qi hides within the bone marrow. When spring arrives and yang qi expands vigorously, the pathogenic qi cannot expel itself. Upon encountering intense summer heat, it combines with the pathogenic qi and manifests. For cases where cold and heat are equal, regulation is appropriate using Biejia Tang (Bie Jia Tang, Turtle Shell Decoction). (The formula is found within this section.)
Taiping Shenghui Fang (Imperial Grace Formulas of the Taiping Era) treats pediatric malaria with alternating chills and fever and body tremors. Huangdan Wan Formula:
Huang Dan (Lead Oxide, lightly stir-fried) Chang Shan (Dichroa Root, powdered. Each half liang) Hu Jing (Tiger Eye, soaked in wine, roasted until yellow)
Grind the above ingredients together into a fine powder. Mix with refined honey to form pills the size of paulownia seeds. Before the onset of an attack, administer two pills with warm water. Children under five years old may take one pill.
Taiping Shenghui Fang treats pediatric malaria presenting with high fever during attacks, increased aversion to cold, greenish-yellow complexion, and inability to eat. Changshan Wan Formula:
Chang Shan (Dichroa Root) Chuan Da Huang (Rhubarb Radix, crushed, lightly stir-fried) Gan Cao (Licorice Root, roasted until slightly red, crushed. Each half liang) She Xiang (Musk, half qian, finely ground)
Pulverize the above ingredients, sieve them, and mix thoroughly with the ground Musk. Use refined honey to form pills the size of paulownia seeds. Just before the onset of an attack, administer two pills with warm water. Children under three years old take one pill.
Taiping Shenghui Fang, another formula:
Burn snake skin to ash, grind finely into a powder. Before the onset of an attack, mix with cold water and administer a dose of "yi zi" (a traditional small measure). Children over two years old take half a qian.
Taiping Shenghui Fang, another formula (Identical to the Qianjin Formula for malaria with heat preceding cold found in that section. Both types of malaria can use this, so both are recorded.)
Take one liang of Bie Jia (Turtle Shell), burn to ash, and grind finely into a powder. Before the onset of an attack, mix with warm wine and administer half a qian. Children under three years old take a dose of "yi zi".
Zhang Huan treats malaria with Tao Ren Tang Formula:
Tao Ren (Peach Kernel, soaked in hot water, peel and tip removed, double-kernel removed, stir-fried with bran until yellow) Bie Jia (Turtle Shell, roasted with butter until slightly yellow, remove skirt edges. Each one liang) Gui Xin (Cinnamon Heart) Huang Qin (Scutellaria Root) Chi Fu Ling (Red Poria) Chuan Sheng Ma (Cimicifuga Rhizome. Each half liang)
Pulverize the above ingredients into a coarse powder. For each dose, take one qian, add one small cup of water, decoct until only half a cup remains, strain, and take warm. Adjust dosage according to the child's age and size.
Quan Sheng Zhi Mi, Biejia Tang:
Bie Jia (Turtle Shell, soaked in hot water, scraped clean, roasted with vinegar) Bai Zhu (Atractylodes Macrocephala Rhizome) Chang Shan (Dichroa Root) Gui (Cinnamon Bark, peeled) Chai Hu (Bupleurum Root, stems removed. Each one liang) Mu Li (Oyster Shell, half liang, calcined until red)
Process the above into a coarse powder. For each dose, take five qian, add two cups of water, decoct until one cup remains, strain, and take warm.